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Research Article International Journal of Family Medicine and Primary Care Published: 17 Feb, 2020

Relationship between Increased Intraocular Pressure in Patients with Hypertension

Christoper J1* and Mardiani TH2 1Department of Medical Record, Haji Adam Malik Hospital, University of Northern Sumatra, Indonesia

2Department of Medicine, University of Northern Sumatra, Indonesia

Abstract Background: Glaucoma is one of the biggest causes of blindness in the world. According to World Health Organization (WHO), there are approximately 39 million people with blindness in the world and around 12 million people are in Southeast Asia. Glaucoma is a chronic optic neuropathy characterized by decreased and cupping of the optic disc. In glaucoma patients, there is usually an increased intraocular pressure which can be caused by several risk factors such as hypertension. Objectives: This study attempts to determine the relationship between increased intraocular pressure in glaucoma patients and hypertension at Haji Adam Malik Hospital in 2018. Material and Methods: This study is an analytic study which is done by collecting intraocular pressure and blood pressure of all glaucoma patients at 2018 from medical records at Haji Adam Malik Hospital. The data was analyzed using chi-square test. Results: Sixty four glaucoma patients’ data were collected from Haji Adam Malik Hospital, there were 39 patients with both hypertension and increased intraocular pressure. Conclusion: The results obtained show that hypertension is a risk factor towards increasing intraocular pressure in glaucoma. Keywords: Glaucoma; Intraocular pressure; Hypertension OPEN ACCESS Introduction *Correspondence: Jason Christoper, Department of Glaucoma is one of the biggest causes of blindness in the world. According to World Health Medical Record, Haji Adam Malik Organization (WHO), there are approximately 39 million people with blindness in the world and around 12 million people are in Southeast Asia [1]. Glaucoma is the second leading cause Hospital, University of Northern of blindness in the world after cataract. Glaucoma is a chronic optic neuropathy characterized Sumatra, Medan, 20136, Indonesia, Tel: by decreased visual field and cupping of the optic disc. In glaucoma patients, there is usually an +628227412203; increased intraocular pressure which can be caused by several risk factors [2]. E-mail: law.jasonchristoper@yahoo. com In the anterior segment of the eye, there is a clear liquid called as aqueous humor that fills Received Date: 10 Jan 2020 anterior and posterior camera. It is produced by the and has a composition similar Accepted Date: 13 Feb 2020 to plasma [3]. The aqueous humor can be drained to the blood vessels through the or . Usually, the increased production of aqueous humor or the decreased drainage Published Date: 17 Feb 2020 can lead to . The increased pressure can damage the of the eye and Citation: cause decreased vision [4]. Christoper J, Mardiani TH. Relationship between Increased Intraocular The exact cause of glaucoma is unknown but there have been several risk factors that contribute to the development of glaucoma, one of the risk factors is hypertension [5]. Hypertension is the term Pressure in Glaucoma Patients with for high blood pressure which means that the blood pumped by the heart is applying a much stronger Hypertension. Int J Fam Med Prim force to the blood vessels. This can damage the blood vessels and cause several complications [6]. Care. 2020; 1(1): 1003. Objectives Copyright © 2020 Christoper J. This is an open access article distributed under In this study, it is proposed that increased intraocular pressure in glaucoma can be caused by the Creative Commons Attribution hypertension. License, which permits unrestricted Materials and Methods use, distribution, and reproduction in any medium, provided the original work Place and year of work is properly cited. The present study was carried out from July to October 2019. The medical records data was

Remedy Publications LLC. 1 2020 | Volume 1 | Issue 1 | Article 1003 Christoper J, et al., International Journal of Family Medicine and Primary Care

Table 1: The analysis of the relationship of increased intraocular pressure with Conclusion hypertension in 64 glaucoma patients using the Chi-square test. Increased intraocular pressure From the result of this study, it is revealed that hypertension is a p-value risk factor towards the development of increased intraocular pressure + - in glaucoma. Nevertheless, these two variables need to be investigated + 39 8 Hypertension 0.044* further together to identify the definitive therapy for both of these - 10 7 diseases and to prevent more people from catching these diseases. *significance at P<0.05 References collected in the Department of Medical Record, Haji Adam Malik Hospital. 1. WHO. 2012 Global data on visual impairments 2010. 2. Eva PR, Augsburger JJ. Vaughan & Asbury General . 19th Ethical considerations ed. New York: McGraw-Hill Medical; 2018. This study has received permission from Health Research Ethical 3. Sherwood L. Introduction to human physiology. 8th ed. Boston:Brooks/ Committee of Faculty of Medicine, University of Northern Sumatra. Cole; 2012 p.393-7. Results 4. Bowling B. Kanskis clinical ophthalmology. 8th ed. Amsterdam. Elsevier; The observation results of the medical records of glaucoma 2016. patients are presented in Table 1. The results show that there are 5. Høvding G. Acute bacterial conjunctivitis. Acta Ophthalmol. 2008;86(1):5- more glaucoma patients with increased intraocular pressure and 17. hypertension compared to other normal intraocular pressure and 6. Langman MJS, Lancashire RJ, Cheng KK, Stewart PM. Systemic blood pressure. hypertension and glaucoma: Mechanisms in common and co-occurrence. Br J Ophthalmol. 2005;89(8):960-63. Discussion 7. Everything you need to know about hypertension. The results of this study aligns with another study done by Ringgo Alfarizi, in which there is a significant p-value (0.044) which shows 8. Alfarizi R. Hubungan Tekanan Darahdengan Peningkatan Tekananintaokuli pada pasien Glaukoma di RSUD. DR.H.ABDUL that hypertension is a risk factor towards the development of increased MOELEK. 2014. intraocular pressure for glaucoma [7]. Plasma that flows to the ciliary body goes through a few processes including active transport, 9. Goel M, Picciani RG, Lee RK, Bhattacharya SK. Aqueous humor dynamics: ultrafiltration and diffusion which produce the aqueous humor that A Review. Open Ophthalmol J. 2010;4:52-59. fills the camera [8]. The amount of aqueous humor production are 10. Grunwald JE, Piltz J, Hariprasad SM, Dupont J, Maguire MG. Optic usually elevated or the drainage system is blocked which can cause an nerve blood flow in glaucoma: Effect of systemic hypertension. AmJ increase in pressure, these alterations have no exact cause but there Ophthalmol. 1999;127(5):516-22. are several risk factors that has been linked to cause these changes and 11. Flammer J, Konieczka K, Flammer AJ. The role of ocular blood flow in hypertension is seen as one of them [5]. the pathogenesis of glaucomatous damage. US Ophthalmic Review. 2011;4(2):84-7. Blood pressure has a direct influence on ocular perfusion and intraocular pressure. High blood pressure persisting in a person can cause damage towards its blood vessels which can disrupt blood flow to the eyes [9]. Also, elevated blood pressure causes vasoconstriction and decreases blood flow. As the blood vessels carry important substances such as oxygen, chronic vasoconstriction and low blood flow can cause nutritional deficit to the eye and therefore can damage the optic nerve [10,11].

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